Nutritional Requirements for a Child With Cancer

The importance of good nutrition

Good nutrition is very important for children being treated for cancer. Children with cancer often have poor appetites due to one, or more, of the following:

The hospital environment

Side effects of chemotherapy and/or radiation

Depression

Pain when eating

Changes in the way food tastes

Side effects from medications

Nausea, vomiting, and diarrhea

Poor nutrition contributes to poor growth. If a child with cancer maintains adequate nutrition, then he/she may be more likely to:

Better tolerate chemotherapy or radiation and with fewer side effects

Heal faster

Grow and develop

Maximize their quality of life

Special diets for children with cancer

Children with cancer often have increased calorie and protein needs. Protein is needed for growth and to help the body repair itself. Getting enough calories can help the body grow, heal, and prevent weight loss. If your child is having trouble eating enough calories and protein, your child's doctor or dietitian may suggest serving high-calorie and high-protein foods (e.g., eggs, milk, peanut butter, and cheese).

Sometimes, even when high-calorie and high-protein foods are offered, children with cancer have trouble eating enough. Tube feedings may be necessary to help give your child adequate nutrition or to prevent malnutrition. This involves placing a small tube (called a nasogastric, or NG tube) through the nose, down the esophagus, and into the stomach. A high-calorie formula or supplement can be given to your child through this tube to help promote appropriate growth and development.

Children undergoing treatment for cancer sometimes need total parenteral nutrition (TPN) to help meet their nutritional needs. TPN is a special mixture of glucose, protein, fat, vitamins, and minerals that is given through an IV into the veins. Many people call this "intravenous feedings." TPN provides the nutrients your child needs when he/she cannot eat or absorb the nutrients from foods. The TPN solution is usually given over several hours each day.

Managing treatment side effects and maintaining proper nutrition

Your child's cancer treatment (chemotherapy, radiation, and surgery) may cause side effects that make it difficult to eat enough food. The following are some of the common side effects and ideas for managing them.

Avoid foods that are fried, greasy, very sweet, spicy, hot, or strong-flavored.

Offer small, frequent meals.

Offer sips of water, juices, sports drinks, or other beverages throughout the day.

Diarrhea

Try to avoid high-fiber foods, including:

Nuts and seeds

Whole grains

Dried beans and peas

Raw fruits and vegetables

Try to limit greasy, fatty, or fried foods.

Limit gassy foods, including:

Beans

Cauliflower

Broccoli

Cabbage

Onions

Offer small, frequent meals and liquids throughout the day.

Limit milk and milk products if lactose intolerance is a problem.

Offer plenty of liquids throughout the day.

Constipation

Offer high-fiber foods, including:

Whole grain breads and cereals

Raw fruits and vegetables

Raisins and prunes

Drink plenty of fluids; hot drinks are sometimes helpful.

Keep the skin on vegetables when cooking them.

Add bran or wheat germ to foods such as casseroles, cereals, or homemade breads.

Tooth decay

Use a soft toothbrush and take your child to the dentist regularly.

Encourage rinsing the mouth with warm water when gums and mouth are sore.

Encourage gently brushing teeth after eating meals and sweets.

Limit foods that stick to the teeth, such as caramels, taffy, gummy candy, or chewy candy bars.

The treatment of cancer can be difficult for anyone of any age. Supportive care (treatment of disease side effects or symptoms) from various members of the health care team, including dietitians and child life therapists, can make the nutritional aspects of treatment less difficult. Suggestions for creating a child-centered environment, making tasty, high-calorie snacks, and possible alternatives to oral nutrition are a part of the supportive care included in the treatment of cancer.

Every child is different and every child tolerates treatment differently. Your child's doctor and health care team will discuss the best method of promoting healthy nutrition during your child's treatment.